{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:07:50Z","timestamp":1787314070169,"version":"build-2736575974"},"reference-count":50,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Pulmonary and Critical Care Medicine"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sleep-related disorders are common among older adults with chronic obstructive pulmonary disease (COPD). Breathing exercises, a key component of pulmonary rehabilitation programs, may improve sleep quality. However, there is a paucity of research on the impact of breathing exercises on sleep quality in elderly patients with COPD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to compare the effects of diaphragmatic breathing (DB) and pursed-lip breathing (PLB) exercises on sleep quality in elderly patients with COPD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Crossover clinical trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this study, 60 elderly patients with COPD were randomly assigned to two groups: DB followed by PLB (Group 1) and PLB followed by DB (Group 2). Each exercise was performed for 4 weeks. Participants completed the Pittsburgh Sleep Quality Index (PSQI), Abbreviated Mental Test Score (AMTS), and COPD Assessment Test (CAT) questionnaires before training. Data were analyzed using descriptive and inferential statistics in SPSS version 21, with a significance level of 0.05.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Both DB and PLB exercises significantly improved sleep quality in elderly patients with COPD ( P\u2009&lt;\u20090.05). No significant difference was found between the two exercises. However, the sequence of exercises in Group 1 (DB followed by PLB) resulted in greater improvement in average sleep quality compared to Group 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates that DB and PLB exercises enhance sleep quality in elderly patients with COPD. These exercises are recommended as an effective non-pharmacological approach to improve sleep quality in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/29768675241302901","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T04:42:17Z","timestamp":1733373737000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparison of the Effects of Diaphragmatic Breathing and Pursed-lip Breathing Exercises on the Sleep Quality of Elderly Patients with Chronic Obstructive Pulmonary Disease (COPD): A Clinical Trial Study"],"prefix":"10.1177","volume":"19","author":[{"given":"Zahra","family":"Dodange","sequence":"first","affiliation":[{"name":"Department of Nursing, Zeyinab (P.B.U.H) School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2825-9685","authenticated-orcid":false,"given":"Azar","family":"Darvishpour","sequence":"additional","affiliation":[{"name":"Department of Nursing, Zeyinab (P.B.U.H) School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran"},{"name":"Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad Javad","family":"Ershad","sequence":"additional","affiliation":[{"name":"Pirouz Hospital, Guilan University of Medical Sciences, Rasht, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahare","family":"Gholami-Chaboki","sequence":"additional","affiliation":[{"name":"Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,12,5]]},"reference":[{"key":"bibr1-29768675241302901","doi-asserted-by":"publisher","DOI":"10.21859\/sija-1202242"},{"key":"bibr2-29768675241302901","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glr251"},{"key":"bibr3-29768675241302901","first-page":"23","volume":"6","author":"Sargazi M","year":"2017","journal-title":"J Multidiscip Care."},{"key":"bibr4-29768675241302901","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00164-2019"},{"key":"bibr5-29768675241302901","first-page":"69","volume":"2","author":"Pedramrazi S","year":"2015","journal-title":"Nurs Pract Today."},{"key":"bibr6-29768675241302901","doi-asserted-by":"publisher","DOI":"10.1080\/15412555.2019.1567701"},{"key":"bibr7-29768675241302901","doi-asserted-by":"publisher","DOI":"10.4103\/0970-2113.56345"},{"key":"bibr8-29768675241302901","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S94268"},{"key":"bibr9-29768675241302901","doi-asserted-by":"publisher","DOI":"10.3109\/15412555.2012.729622"},{"key":"bibr10-29768675241302901","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.02912"},{"key":"bibr11-29768675241302901","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201309-1634ST"},{"key":"bibr12-29768675241302901","first-page":"781","volume":"4","author":"Premkumar K","year":"2019","journal-title":"Int J Innov Sci Res Technol."},{"key":"bibr13-29768675241302901","doi-asserted-by":"publisher","DOI":"10.18502\/kls.v6i1.8589"},{"key":"bibr14-29768675241302901","first-page":"267","volume":"23","author":"Behzadinezhad S AA","year":"2018","journal-title":"Armaghane Danesh."},{"key":"bibr15-29768675241302901","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.07121"},{"key":"bibr16-29768675241302901","doi-asserted-by":"publisher","DOI":"10.11648\/j.ajns.20200904.28"},{"key":"bibr17-29768675241302901","doi-asserted-by":"publisher","DOI":"10.1111\/psyp.12333"},{"key":"bibr18-29768675241302901","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2020.12.003"},{"key":"bibr19-29768675241302901","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.06319"},{"key":"bibr20-29768675241302901","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18103\/mra.v6i1.1609","volume":"6","author":"Zhang W","year":"2018","journal-title":"Med Res Arch."},{"key":"bibr21-29768675241302901","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1975.03240150051030"},{"key":"bibr22-29768675241302901","doi-asserted-by":"publisher","DOI":"10.1080\/09593985.2020.1805834"},{"key":"bibr23-29768675241302901","unstructured":"Izadi-Avanji FS, Adib-Hajbaghery M. 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